Platelet-rich plasma in the treatment of alopecia

<p>Platelet rich plasma (PRP) is a promising treatment choice for patients with thinning hair. Despite excellent clinical safety and low cost, its clinical standing is still weak. The effectiveness of this method depends on its dosage, number of sessions, their intervals and technique of injection incorporated. PRP can produce particularly some phenomenal effects when applied in cosmetic dermatology. The therapeutic value of PRP is equivalent to stem cells and considered as one of the promising therapeutic agents in regenerative medicine. Harvesting of PRP plays a significant role, which is obtained from the patient's blood after centrifugation of the sample i.e., the platelet concentrates above the baseline which is the plasma fraction of the autologous blood. There are many applications of PRP in the medical field and has an incredibly significant role in dermatologic conditions e.g., tissue regeneration, wound healing, scar revision, skin rejuvenation and alopecia. In this review, we will be analyzing the authenticity of the use of PRP in the treatment of alopecia. PRP, in current scenario, is considered as a novel treatment modality. The efficacy of PRP therapy carries some deficiencies, which include lacking standard in preparation and concentration of platelets in PRP.</p><p><strong> </strong></p>

Beneficial Effects of a Plasma Fraction on Inflammation and Synaptic Deficits for Age-Related Cognitive Disorders

The process of aging is multifactorial, and therefore single agent interventions would be unlikely to attenuate the myriad pathologies associated with advancing age. Plasma contains many beneficial factors which have been shown in animal models to ameliorate multiple age-related deficits across varied organ systems, including the brain. We confirmed that human plasma from young (18-22-year-old) donors reverses age-related cognitive decline and enhances hippocampal neurogenesis and cell survival in aged immunocompromised mice, while plasma from aged individuals (62-68 years old) has detrimental effects in young mice. We examined PF in a high-fat diet (HFD) mouse model, a surrogate for a western diet, which expresses many characteristics of aging within the CNS in an accelerated manner: decreased cell proliferation, synaptic connectivity and increased inflammation compared to normal diet (NC) controls. We demonstrate that PF administration in HFD mice resulted in decreased brain inflammation, increased synaptic connectivity, improved neural progenitor cell survival, as well as amelioration of behavioral endpoints without impacting the underlying metabolic changes induced by HFD. In summary, we demonstrate that PF is a multifactorial and multimodal intervention for the treatment of global changes induced by the process of aging.

Deep Longitudinal Proteomics Profiling Reveals Biological Pathways Responding to GRF6019 in Two AD Clinical Trials

Blood has been widely investigated to discover biomarkers and gain insights into the biology of aging and age-related diseases. Its protein composition provides insights into complex biological processes, as proteins are often direct regulators of cellular pathways. In clinical trials, selected proteins have been used as primary and secondary endpoints, but recent methodological developments allow the measurement of thousands of proteins with very high sensitivity and specificity. In two phase 2 clinical trials testing the safety, tolerability, and feasibility of infusions of the plasma fraction GRF6019 in Alzheimer's disease (AD), we measured more than 7000 proteins in plasma over the course of the clinical trials. Differential trajectories analysis revealed groups of proteins and pathways that were responding to GRF6019. Several pathways were relevant to the biology of aging and AD and our study suggests that deep proteomics profiling can inform on specific biological processes responding to treatment in clinical trials.

Advantages and Clinical Applications of Lyophilized Platelet-Rich Plasma in Various Disease Conditions: A Review

Platelet rich plasma (PRP) is a biological product defined as a portion of the plasma fraction of autologous blood with a platelet concentration above the baseline. The plasma occupies 55% of blood, which is rich in immunoglobulins and proteins that have a wide range of applications in various medical fields. Plasma therapy is applied to tackle various disorders or diseases as it induces the body to develop new healthy cells. It contains important components like antibodies, coagulation factor, enzymes, fibrinogen, proteins and albumin. PRP is a unique and advanced treatment which helps to increases the body’s natural healing process. Platelet lysate which is obtained from platelet rich plasma consist of various growth factors such as chemokines, cytokines, and antibacterial molecules and also has anti-inflammatory, immunomodulatory, anti-fibrotic and repairing effects. As PRP is rich in the proteins and several antibodies, it is used for various chronic therapies such as hemophilia and autoimmune disorders as well as in various severe health problems. Lyophilized Platelet-rich plasma (LPRP) therapy is currently used in various fields such as in tissue regeneration, wound healing, scar revision, skin rejuvenating effects, alopecia and for the coronavirus disease (COVID-19). It is also used to heal wounds and illnesses. LPRP therapy is gaining attraction by many health professionals as it is a safe, effective, efficient, and easy approach in procuring, preserving, and therapy. In this review we described the advantages and applications of using lyophilized PRP in various diseases which might found to be effective in different treatment. Keywords: Plasma, Platelet, Growth Factors, Lyophilized platelet rich plasma.

A boomy century of periodontal regeneration with biological mediators

With the advanced and improved knowledge of bone regeneration on the molecular level, some of key molecules that alter the complicated physiological method were identified, and are already in scientific use or beneath research to enhance bone restore. Of those molecules, BMPs were the maximum considerably studied, as they are robust osteoinductive elements. They result in the mitogenesis of mesenchymal stem cells (MSCs) and different osteoprogenitors, and their differentiation in the direction of osteoblasts. Other growth factors except BMPs which have been implicated through out the bone regeneration, with one-of-a-kind features with respect of cell proliferation, chemotaxis and angiogenesis, are also being investigated or are presently getting used to reinforce bone restore, which include platelet-derived growth factor, transforming growth factor- β, insulin-like growth factor-1, vascular endothelial growth factor and fibroblast growth factor, amongst others. One present day technique to enhance bone regeneration and soft-tissue recovery with the aid of using nearby application of growth factors is the use of platelet-rich plasma, an extent of the plasma fraction of autologous blood with platelet concentrations above baseline, that is wealthy in most of the aforementioned molecules. This overview focuses and target on the biological mediators that regulates key cellular events which have a capacity to induce the method of tissue repair and regeneration.

Phase I/II Study of LDE225 in Combination with Gemcitabine and Nab-Paclitaxel in Patients with Metastatic Pancreatic Cancer

Background: Desmoplasia is a central feature of the tumor microenvironment in pancreatic ductal adenocarcinoma (PDAC). LDE225 is a pharmacological Hedgehog signaling pathway inhibitor and is thought to specifically target tumor stroma. We investigated the combined use of LDE225 and chemotherapy to treat PDAC patients. Methods: This was a multi-center, phase I/II study for patients with metastatic PDAC establishing the maximum tolerated dose of LDE225 co-administered with gemcitabine and nab-paclitaxel (phase I) and evaluating the efficacy and safety of the treatment combination after prior FOLFIRINOX treatment (phase II). Tumor microenvironment assessment was performed with quantitative MRI using intra-voxel incoherent motion diffusion weighted MRI (IVIM-DWI) and dynamic contrast-enhanced (DCE) MRI. Results: The MTD of LDE225 was 200 mg once daily co-administered with gemcitabine 1000 mg/m2 and nab-paclitaxel 125 mg/m2. In phase II, six therapy-related grade 4 adverse events (AE) and three grade 5 were observed. In 24 patients, the target lesion response was evaluable. Three patients had partial response (13%), 14 patients showed stable disease (58%), and 7 patients had progressive disease (29%). Median overall survival (OS) was 6 months (IQR 3.9–8.1). Blood plasma fraction (DCE) and diffusion coefficient (IVIM-DWI) significantly increased during treatment. Baseline perfusion fraction could predict OS (>222 days) with 80% sensitivity and 85% specificity. Conclusion: LDE225 in combination with gemcitabine and nab-paclitaxel was well-tolerated in patients with metastatic PDAC and has promising efficacy after prior treatment with FOLFIRINOX. Quantitative MRI suggested that LDE225 causes increased tumor diffusion and works particularly well in patients with poor baseline tumor perfusion.

Sulfated agaran with 4,6-pyruvated form from red seaweed Acanthophora muscoides attenuates thrombin formation: in vitro and ex vivo studies

In vitro studies have described the sulfated agaran from Acanthophora muscoides as an intrinsic inhibitor of thrombin generation (TG), but not in ex vivo assay. This investigation partially characterized a pyruvate fraction with in vitro and ex vivo effects on an intrinsic/extrinsic pathway-induced thrombin generation (TG) continuous model using 36 or 60-fold diluted mice or defibrinated, normal human plasma. Fraction separated by DEAE-cellulose chromatography exhibited charge homogeneity and non-sulfated polysaccharides (<100 kDa) by agarose and polyacrylamide gel electrophoresis, respectively, using Stains-all alone. Fourier Transform Infrared and Nuclear Magnetic Resonance studies indicated a 4,6-pyruvated agaran-structure. The fraction and heparin had no effect on prothrombin time, but there was a preponderant intrinsic rather than extrinsic pathway inhibition in TG assay; themselves, acting on both free and fibrin bound thrombin activity without chromogenic substrate interaction. Both fractions, desulfated and native, anticipated and induced thrombin formation in activators-devoid or normal plasma. In addition, mice pretreated with fraction (20 mg kg-1, intraperitoneally) reduced intrinsically plasma TG ex vivo after 2h. Heparin suppressed TG in vitro, but induced it ex vivo. Therefore, agaran from A. muscoides blocks TG on in vitro and ex vivo studies, suggesting to evaluate the blood coagulability status.

THE EFFICACY OF PLATELET RICH PLASMA IN TREATMENT OF ANDROGENETIC ALOPECIA

Dermoscopy is a non-invasive diagnostic technique for the observation of pigmented skin lesions, permitting the recognition of morphologic structures not visible by the naked eye. The technique consists of placing mineral oil, alcohol or even water on the skin lesion that is subsequently inspected using a hand-held lens, a hand-held dermatoscope, a stereomicroscope, a camera, or a digital imaging system. The magnifications of these various instruments range from 6x even up to 100x.The fluid placed on the lesion eliminates surface reflection and renders the cornified layer translucent, thus allowing a better visualization of pigmented structures within the epidermis, the dermoepidermal junction and the superficial dermis. Male-pattern hair loss (MPHL), also known as androgenic alopecia and male pattern baldness, is hair loss that occurs due to an underlying susceptibility of hair follicles toshrinkage due to the influence of androgenic hormones. Male-pattern hair loss is the most common cause of hair loss and will affect up to 70% of men and 40% of women at some point in their lifetimes.Men typically present with progressive hair loss at the temples and vertex balding, whereas women typically present with diffuse hair loss over the top of their scalps.Platelet-rich plasma is defined as a volume of the plasma fraction of autologus blood with an above baseline platelet concentration usually more than 1,000,000 platelets/μL.PRPs regenerative potential depends on the levels of released GFs.Alpha granules of platelets contain GFs, which upon activation, are responsible for the initiation and maintenance of the healing response. PRP is known to carry more than 20 GFs and other protein molecules, such as adhesion molecules, chemokines, which interact to promote inflammation, cell proliferation, differentiation, and regeneration.In this study, the aim was to objectively assess the proposed therapeutic effect of PRP in treatment of AGA through measuring hair density using dermoscopic evaluation, hair pull test, gross pictures and patients satisfaction scale.The study included 30 patients of different grades of androgenetic alopecia, our patients were 15 males and 15 females ranging from grade Ι to ΙΙΙ by Ludwig classification for FPHL and from grade 3 to grade 6 for Norwood and Hamilton classification for male androgenetic alopecia of a total 6 sessions, 4 successive ones with 3 weeks apart of a total 12 weeks and 2 separate sessions, 24wk and the last evaluation was done 1 year later to the 1st session.The results were classified depending on the lasting effect of the PRP into short term results lasting up to 4 months from the start of the sessions which gave statistically positive values regarding the hair pull test results and hair follicles counted by dermoscope and the long term results starting from the 5th month up to 1 year duration from the start of the sessions which showed decline in both numbers of hair pull test and Which indicatesthe needfo retreatment or addition of another line o medical treatment e.g., minoxidil or finasteride. Also PRP can be considered ahumble tool in the treatment of AGA, as it is sufficient alone without the medical treatment.

A Longitudinal Study on Hematocrit Changes after Glifozins Exposure in Patients with Type 2 Diabetes

Background and Methods: Gliflozins are widely prescribed drugs in patients with type 2 diabetes. We pursue to explain abnormal increments in red cell parameters observed in this population, by means of a longitudinal study in 149 patients with a gliflozins exposure period of 12±6 months. Red cell parameters, HbA1c and other variables were recorded. Results: HbA1c fraction decreased (-0.5±1.3, 95% CI: -0.7 to -0.3, p<0.001), while mean hemoglobin (0.5±0.9, 95% CI: 0.3 to 0.6, P<0.001) and hematocrit (1.6±2.6, 95% CI: 1.2 to 2.0, P<0.001) increased. Mean (SD) hematocrit increased 2.7±1.9 in 112 patients, and decreased -1.7±1.5 in 37 (p<0.001 for subgroup differences). The larger increments in PCV were proportional to higher plasma fraction at baseline (p=0.009). Conclusion: Red cell parameters after gliflozins exposure tend to increase and may reach abnormally high thresholds in some patients with type 2 diabetes.